Influence of gastrointestinal factors on glucose metabolism in patients with cirrhosis
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Influence of gastrointestinal factors on glucose metabolism in patients with cirrhosis. / Junker, Anders E; Gluud, Lise L; Holst, Jens Juul; Knop, Filip K; Vilsbøll, Tina.
In: Journal of Gastroenterology and Hepatology, Vol. 30, No. 10, 10.2015, p. 1522-8.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Influence of gastrointestinal factors on glucose metabolism in patients with cirrhosis
AU - Junker, Anders E
AU - Gluud, Lise L
AU - Holst, Jens Juul
AU - Knop, Filip K
AU - Vilsbøll, Tina
N1 - This article is protected by copyright. All rights reserved.
PY - 2015/10
Y1 - 2015/10
N2 - BACKGROUND AND AIMS: The impaired glucose tolerance in cirrhosis is poorly understood. We evaluated the influence of gastrointestinal-mediated glucose disposal and incretin effect in patients with cirrhosis.METHODS: Non-diabetic patients with Child Pugh A or B cirrhosis (n = 10) and matched healthy controls (n = 10) underwent a 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). We presented data as median ± interquartile range and compared groups using non-parametric analysis of variance.RESULTS: Patients with cirrhosis were glucose intolerant compared to healthy controls (4 hour OGTTAUC : 609 ± 458 vs. 180 ± 155 min x mmol/L; P = 0.005), insulin resistant (homeostatic model assessment (HOMAIR ): 3.7 ± 4.9 vs. 2.6 ± 1.4; P = 0.014) and had fasting hyperglucagonemia (8 ± 3 vs. 3 ± 4 pmol/L; P = 0.027). Isoglycemia was achieved using 35 ± 12 g of intravenous glucose in patients with cirrhosis compared to 24 ± 10 g in healthy controls (P = 0.003). The gastrointestinal-mediated glucose disposal was markedly lower in patients with cirrhosis (30 ± 23 vs. 52 ± 20%; P = 0.003). Despite higher levels of the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) patients with cirrhosis had reduced incretin effect (35 ± 44 vs. 55 ± 30%; P = 0.008).CONCLUSIONS: Impaired gastrointestinal-mediated glucose disposal and reduced incretin effect may contribute to the glucose intolerance seen in patients with cirrhosis.
AB - BACKGROUND AND AIMS: The impaired glucose tolerance in cirrhosis is poorly understood. We evaluated the influence of gastrointestinal-mediated glucose disposal and incretin effect in patients with cirrhosis.METHODS: Non-diabetic patients with Child Pugh A or B cirrhosis (n = 10) and matched healthy controls (n = 10) underwent a 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). We presented data as median ± interquartile range and compared groups using non-parametric analysis of variance.RESULTS: Patients with cirrhosis were glucose intolerant compared to healthy controls (4 hour OGTTAUC : 609 ± 458 vs. 180 ± 155 min x mmol/L; P = 0.005), insulin resistant (homeostatic model assessment (HOMAIR ): 3.7 ± 4.9 vs. 2.6 ± 1.4; P = 0.014) and had fasting hyperglucagonemia (8 ± 3 vs. 3 ± 4 pmol/L; P = 0.027). Isoglycemia was achieved using 35 ± 12 g of intravenous glucose in patients with cirrhosis compared to 24 ± 10 g in healthy controls (P = 0.003). The gastrointestinal-mediated glucose disposal was markedly lower in patients with cirrhosis (30 ± 23 vs. 52 ± 20%; P = 0.003). Despite higher levels of the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) patients with cirrhosis had reduced incretin effect (35 ± 44 vs. 55 ± 30%; P = 0.008).CONCLUSIONS: Impaired gastrointestinal-mediated glucose disposal and reduced incretin effect may contribute to the glucose intolerance seen in patients with cirrhosis.
U2 - 10.1111/jgh.12981
DO - 10.1111/jgh.12981
M3 - Journal article
C2 - 25867498
VL - 30
SP - 1522
EP - 1528
JO - Journal of Gastroenterology and Hepatology
JF - Journal of Gastroenterology and Hepatology
SN - 0815-9319
IS - 10
ER -
ID: 137418841